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    Affidavit Declaration of Vaccination Exemption

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    Blubombshell Jones
    This affidavit declares an exemption from immunization for the adult and minor named based on personal and religious beliefs. It cites Senate Bill 942, which provides exemptions from immunization for medical reasons or personal beliefs. The bill states that immunizations shall not be required for school admission if a letter or affidavit is filed stating immunization is contrary to beliefs. The affidavit asserts that enforcing vaccination would violate the 14th and 4th Amendments of the U.S. Constitution protecting privileges, life, liberty, and being secure in one's person.

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    Affidavit Declaration of Vaccination Exemption

    Uploaded by

    Blubombshell Jones
    1K views1 page
    This affidavit declares an exemption from immunization for the adult and minor named based on personal and religious beliefs. It cites Senate Bill 942, which provides exemptions from immunization for medical reasons or personal beliefs. The bill states that immunizations shall not be required for school admission if a letter or affidavit is filed stating immunization is contrary to beliefs. The affidavit asserts that enforcing vaccination would violate the 14th and 4th Amendments of the U.S. Constitution protecting privileges, life, liberty, and being secure in one's person.

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    Affidavit Declaration of Vaccination Exemption for adult and minor child.

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    This affidavit declares an exemption from immunization for the adult and minor named based on personal and religious beliefs. It cites Senate Bill 942, which provides exemptions from immunization for medical reasons or personal beliefs. The bill states that immunizations shall not be required for school admission if a letter or affidavit is filed stating immunization is contrary to beliefs. The affidavit asserts that enforcing vaccination would violate the 14th and 4th Amendments of the U.S. Constitution protecting privileges, life, liberty, and being secure in one's person.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    1K views1 page

    Affidavit Declaration of Vaccination Exemption

    Uploaded by

    Blubombshell Jones
    This affidavit declares an exemption from immunization for the adult and minor named based on personal and religious beliefs. It cites Senate Bill 942, which provides exemptions from immunization for medical reasons or personal beliefs. The bill states that immunizations shall not be required for school admission if a letter or affidavit is filed stating immunization is contrary to beliefs. The affidavit asserts that enforcing vaccination would violate the 14th and 4th Amendments of the U.S. Constitution protecting privileges, life, liberty, and being secure in one's person.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    AFFIDAVIT

    DECLARATION OF VACCINATION EXEMPTION


    Pursuant to Senate Bill # 942, Section 1 Chapter # 7, under the title “Exemption From
    Immunization,” I hereby declare that I, as the adult parent/guardian, have responsibility for
    myself, xxxx and my child, xxxx, who is a minor, withhold my consent and let it be known that
    said adult and minor is exempt from any and all immunizations and/or vaccinations on the
    grounds that such is contrary to my personal and/or religious beliefs.
    SENATE BILL #942, SECTION 1, CHAPTER 7
    3380 – IN ENACTING THIS CHAPTER, IT IS THE INTENT OF THE LEGISLATURE TO
    PROVIDE: … (C) EXEMPTION FROM IMMUNIZATION FOR MEDICAL REASONS OR
    PERSONAL BELIEFS.
    3385 – IMMUNIZATIONS OF A PERSON SHALL NOT BE REQUIRED FOR ADMISSION
    TO A SCHOOL OR OTHER INSTITUTION … IF THE GUARDIAN, PARENT, OR ADULT
    WHO HAS ASSUMED RESPONSIBILITY FOR HIS OR HER CUSTODY AND CARE IN
    THE CASE OF A MINOR, OR THE PERSON SEEKING ADMISSION, FILES WITH THE
    GOVERNING AUTHORITY, A LETTER OR AFFIDAVIT STATING THAT SUCH
    VACCINATION IS CONTRARY TO HIS/HER BELIEFS …
    Any school or medical authority which tries to enforce vaccination on children or anyone else is
    in violation of the laws of the United States, and may be subject to prosecution.
    Amendment 14 of the United States Constitution: “No state shall make or impose any law which
    shall abridge the privileges or immunities of the citizens of the United States, nor shall any state
    deprive any person of life, liberty, or property.”
    Amendment 4 of the United States Constitution: “The right of the people to be secure in their
    persons shall not be violated.”

    _______________________________________________ __________________
    SIGNATURE UCC 1-308, VA Code § 8.1A-308 DATE
    WITHOUT PREJUDICE, WITHOUT RECOURSE, ALL RIGHTS RESERVED

    SUBSCRIBED AND AFFIRMED BEFORE ME ON THIS _____ DAY OF _______________,


    _________.

    ______________________________ ________________
    NOTARY PUBLIC SIGNATURE DATE

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